SF supes demand Sutter Health keep long-term beds in Mission

St. Luke's Hospital in the Mission District is slated for the chopping block. Long-term patients will go to other counties.

St. Luke's Hospital in the Mission District is slated for the...

Four San Francisco supervisors demanded Wednesday that Sutter Health keep the doors open at its Mission District facility for long-term and acutely sick patients. The nonprofit had planned to close it in October.

The request came at the end of a raucous, at times tearful meeting of the supervisors’ Public Safety and Neighborhood Services Committee, where scores of doctors, nurses and patient relatives accused Sutter of putting money ahead of the sick and dying.

“We want you to go back to your executives and say, ‘Our staff is unified, the supervisors are unified, the Department of Public Health is unified — they all want to keep this unit open,’” said committee chair Supervisor Hillary Ronen.

“And I hope that when we call (another) hearing in September, that that’s what we’ll be hearing from your hospital,” she said.

The closure of San Francisco’s only subacute nursing unit is part of a plan to make way for two new hospitals in Sutter’s California Pacific Medical Center network — one to replace St. Luke’s Hospital in the Mission, which houses the doomed subacute and skilled nursing unit, the other at Van Ness Avenue and Geary Boulevard.

The new St. Luke’s campus, renamed Mission Bernal Campus, will open next year, and the building at Van Ness and Geary will follow in 2019. Once they open, Sutter will demolish the old St. Luke’s Hospital, hewing to an agreement it negotiated with the city in 2013 to build the new hospital on Van Ness.

That agreement didn’t require Sutter to keep any subacute beds in San Francisco.

Both new hospitals are only licensed to have regular beds, which are expected to fill up daily with surgery patients, mothers delivering babies and other people with medical emergencies, said Mary Lanier, chief administrative officer at California Pacific Medical Center.

“The beds we will have in the new configuration will be full,” Lanier said during Wednesday’s meeting.

She said the new hospitals would not have room for subacute beds, which are reserved for people with severe conditions who need long-term care.

There appears to be little demand for those beds in San Francisco. The unit that’s shuttering at St. Luke’s has 79 beds, 40 of which are for subacute patients. Twenty-four of those subacute beds are filled, with one patient awaiting discharge later this week.

But as San Francisco’s population ages, demand for these 24-hour care services is expected to grow. The city will likely need about 2,000 additional skilled nursing beds by 2030, said Colleen Chawla of the city’s Department of Public Health.

Nurses and doctors were quick to denounce Sutter’s plan at the hearing Wednesday, saying it showed little compassion for the people with terminal illnesses who would be shipped off to other counties.

Ronen and fellow Supervisors Jeff Sheehy, Sandra Lee Fewer, and Ahsha Safai — who called the hearing — also had strong criticism for Sutter Health.

“I feel like this is a violation of the Hippocratic oath: ‘Do not harm,’” said Sheehy, who is the only HIV-positive supervisor and a fierce advocate for survivors of the AIDS epidemic.

“Every doctor commits to that,” Sheehy continued, “but is that anywhere in the mission of Sutter?”

He and the other supervisors accused the health network of basing its decisions on money. Many of the critically ill patients who need ongoing care are beneficiaries of the state’s Medi-Cal assistance program, which limits reimbursement rates for hospitals.

Ronen saw Sutter’s move as “a symptom of the overall broken health care system in the U.S.”

“We are going to fight the efforts of individual hospitals that in name are nonprofit, but actually seem to be for-profit,” she said.

Sutter spokeswoman Stacey Wells disagreed, noting that the network is “the largest provider of care to Medi-Cal patients in Northern California, a fact we know the supervisors greatly appreciate.”

Chawla said Sutter’s plan to close the facility at St. Luke’s reflects a national trend, as hospitals with skilled nursing and subacute beds shut down and shift those patients to other types of facilities that are less expensive to operate.

San Francisco currently has 2,502 skilled nursing beds at various locations. If the unit at St. Luke’s closes, the city will no longer have spots for subacute patients, who can still be served at 11 other locations in the Bay Area.